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Percutaneous endoscopic gastrostomy. Review of 150 cases
Insights
Percutaneous endoscopic gastrostomy (PEG) is a safe and effective feeding tube procedure for both children and adults. This study found PEG had low morbidity and no procedure-related deaths, making it the preferred method.
Area of Science:
- Gastroenterology
- Endoscopic Procedures
- Pediatric Surgery
Background:
- Feeding gastrostomies are crucial for nutritional support in various patient populations.
- Traditional methods for gastrostomy creation often involve invasive surgical procedures.
- The development of percutaneous endoscopic gastrostomy (PEG) offered a less invasive alternative.
Purpose of the Study:
- To evaluate the safety and efficacy of percutaneous endoscopic gastrostomy (PEG) in a large cohort of pediatric and adult patients.
- To assess the complication rates and outcomes associated with the PEG procedure.
- To determine if PEG is a suitable alternative to traditional surgical gastrostomy.
Main Methods:
- A retrospective review of 50 pediatric and 100 adult patients who underwent PEG between June 1979 and May 1982.
- Data collection focused on procedure-related complications, morbidity, and mortality.
- Analysis of specific complications such as wound infections, tube displacement, and fistulas.
Main Results:
- The study included 150 patients (50 children, 100 adults) undergoing PEG.
- Overall morbidity was low at 10%, with no procedure-related deaths.
- Identified complications included minor wound infections, tube extrusion, and one case each of partial separation and gastrocolic fistula, with the latter resolving after tube removal.
Conclusions:
- Percutaneous endoscopic gastrostomy (PEG) is a rapid, safe, and effective method for creating feeding gastrostomies.
- The procedure does not necessitate general anesthesia or laparotomy, enhancing patient safety.
- PEG should be considered the preferred method for establishing feeding gastrostomies due to its favorable risk-benefit profile.
Abstract:
Percutaneous endoscopic gastrostomy was performed on 50 children and 100 adults from June 1979 to May 1982 at Case Western Reserve University Hospitals and the Mt Sinai Medical Center in Cleveland. Morbidity was low (10%), and there were no procedure-related deaths. Complications included minor wound infections in seven patients early in the series, extrusion of the tube in three, unnecessary laparotomy in two suspected of having problems with the tube early in the series, a partial separation of the gastrostomy from the abdominal wall in one adult, and gastrocolic fistula in one adult and one child. The last condition disappeared after removal of the gastrostomy tube in both patients. No leakage around the catheter, hemorrhage, peritonitis, or gastric outlet obstruction was encountered. This procedure provided a rapid, safe, and effective method for creating a feeding gastrostomy and did not require general anesthesia and laparotomy. Percutaneous endoscopic gastrostomy should become the method of choice for the creation of a feeding gastrostomy.